Rating Schedule for The Elbow and Forearm
IMPORTANT NOTE:
For the purposes of Range of Motion (ROM), the examiner/rater are REQUIRED to consider flair ups in your conditions. Meaning, if you do not happen to have an Examination on your worst day, the examiner is required to reasonably estimate your impairment on your worst day! The rater is required to use this estimate, unless your ROM is somehow noted as being worse during ROM testing during the exam. In any event, the rater is to use the most impaired ROM measurements noted by the examiner!
Amputation Rule
Veterans CANNOT have a total Combined rating of over 80% for musculoskeletal conditions for their dominant forearm down or 70% for their non-dominant forearm down.
IMPORTANT NOTE:
For Veterans who are ambidextrous the affected limb WILL be considered dominant.
5123/5124 Amputation
Veteran is entitled to Special Monthly Compensation.
| Dominant Rating |
Non-Dominant Rating |
Degree of Amputation |
|---|---|---|
| 70% | 60% | Below the middle of the forearm. |
| 80% | 70% | Above the middle of the forearm. |
Loss of Use (Ankylosis)
When you cannot move the joint.
5205 Elbow Ankylosis
Inability to bend or straighten your forearm at all.
Pronation: Palms down.
Supination: Turning the arm
| Dominant Rating |
Non-Dominant Rating |
Description |
|---|---|---|
| 40% | 30% | Stuck between 90° and 70°. |
| 50% | 40% | Stuck more than 90°, or between 70° and 50°. |
| 60% | 50% | Less than 50°; OR with COMPLETE loss of supination or pronation. |
5213a Forearm Ankylosis
Inability to twist your hand at all.
Hyperpronation: Palms are down and the radius bone has dislocated.
Pronation: Palms down.
Supination: Palms up.
| Dominant Rating |
Non-Dominant Rating |
Description |
|---|---|---|
| 20% | 20% | The hand fixed near the middle of the arc or moderate pronation. |
| 30% | 20% | The hand fixed in full pronation. |
| 40% | 30% | The hand is fixed in supination or hyperpronation. |
5052 Elbow Replacement (Prosthesis)
| Dominant Rating |
Non-Dominant Rating |
Description |
|---|---|---|
| 30% | 20% | Minimum Rating. |
| 50% | 40% | Chronic residuals consisting of severe painful motion or weakness. |
| 100% | 100% | For 1 year following the replacement. After which Veteran will be rated based upon their residual symptoms. |
Ratings Based Off Limitations of Range of Motion (ROM)
PYRAMIDING NOTES:
The Veteran CAN receive a rating for BOTH extension and flexion, based on ROM limitations.
The Veteran CAN ALSO get a separate rating pronation OR supination.
In total, 3 different ROM ratings can be awarded for the elbow/forearm!
5206/5207/5208 Elbow ROM
The ability to straighten your arm (Extension) or bend your arm (Flexion).
SPECIAL RATING:
If the Veteran can only straighten their arm to 45° AND only bend their arm to 100° then they will receive a 20% rating. This 20% rating is the same for the dominant or non-dominant arm.
| Dominant Rating |
Non-Dominant Rating |
Limited Extension | Limited Flexion |
|---|---|---|---|
| 0% | 0% | - | 110°. |
| 10% | 10% | 45°-60°. | 100°. |
| 20% | 20% | 75°. | 90°. |
| 30% | 20% | 90°. | 70°. |
| 40% | 30% | 100°. | 55°. |
| 50% | 40% | 110°. | 45°. |
5213b Forearm ROM
The ability to twist your arm palm down (pronation) or palm up (supination).
| Dominant Rating |
Non-Dominant Rating |
Limited Pronation | Limited Supination |
|---|---|---|---|
| 10% | 10% | - | To 30° or less |
| 20% | 20% | Motion lost beyond last quarter of arc, the hand does not approach full pronation. | - |
| 30% | 20% | Motion lost beyond middle of arc. | - |
Elbow & Forearm Bones
5209b Elbow Joint
| Dominant Rating | Non-Dominant Rating | Description |
|---|---|---|
| 20% | 20% | Joint fracture, with marked cubitus varus or cubitus valgus deformity or with ununited fracture of head of radius. |
5211 Ulna Bone
The bone within the forearm that is on the opposite side of the thumb.
| Dominant Rating | Non-Dominant Rating | Description |
|---|---|---|
| 10% | 10% | Bone healed improperly. |
| 20% | 20% | Bone will not heal, in just the part of the bone nearest the hand. |
| 30% | 20% | Without loss of bone substance or deformity. |
| 40% | 30% | At least one inch of bone is missing. |
5212 Radius Bone
The bone within the forearm that is on the same side as the thumb. These ratings are for then this bone causes there to be extra motion in the forearm; but it is NOT significant.
| Dominant Rating | Non-Dominant Rating | Description |
|---|---|---|
| 10% | 10% | Bone healed improperly. |
| 20% | 20% | Bone will not heal, in just the part of the bone nearest the hand. |
| 30% | 20% | Without loss of bone substance or deformity. |
| 40% | 30% | At least one inch of bone is missing. |
Miscellaneous Ratings
PYRAMIDING NOTE:
The Veteran will NOT receive an additional rating if they fit the criteria of any of these miscellaneous cases. The Veteran will get a single rating for the ROM or Miscellaneous rating; whichever rating is higher!
Arthritis
When a Veteran's arthritis does not warrant a rating based upon ROM or other miscellaneous situations. The Veteran's condition will be rated under degenerative arthritis.
For an explanation of arthritis ratings click HERE.
Pain with Motion
PYRAMIDING NOTE:
When there is an award based on pain with motion with movement of the elbow. The VA will CAN award up to TWO ratings! One for pronation/supination and one for extension/flexion. HOWEVER, you CANNOT get separate ratings for say pain with motion of pronation and supination or extension and flexion, based upon pain with motion.
| Rating |
Description |
|---|---|
| 10% | Pain with motion. |
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